Die degenerative adulte lumbale de novo Skoliose – Evidenz

Zusammenfassung

Die adulte lumbale degenerative lumbale Skoliose bietet sehr oft eine heterogene strukturelle Befundlage. Foraminale und zentrale Stenosen sowie lokale oder globale Instabilitäten begründen oft massive Beschwerden. Darüber hinaus ist die sagittale und frontale Deformität für Symptome ausschlaggebend. Das selektive oder „kurzstreckige“ Vorgehen erfordert die eindeutige Eingrenzung der strukturellen, Schmerzen auslösenden Ursache sowie die Berücksichtigung der Regeln der Deformitätenkorrektur. Werden die Prinzipien angewandt, ergibt sich die Möglichkeit zum selektiven Vorgehen. Der Artikel fasst die Evidenzlage zusammen.

Abstract

Adult lumbar degenerative scoliosis very often presents with heterogenous structural findings. Foraminal and central stenoses as well as local or global instabilities often give rise to massive complaints. In addition, sagittal and frontal deformity is crucial for symptoms. The selective or “short” surgical approach requires the clear identification of the structural cause triggering pain as well as consideration of the rules of deformity correction. If all principles are applied correctly, the option of a selective surgery arises. This article summarizes the evidence.

Schlüsselwörter

Degenerative adulte Skoliose - Selektive Chirurgie - Korrekturregeln

Keywords

Degenerative adult scoliosis - Selective Surgery - Rules for correction

Publication History

Article published online:
04 March 2022

• Literatur

• 1 Aebi M. The adult scoliosis. Eur Spine J 2005; 14: 925-948
• 2 Phan K, Xu J, Maharaj MM. et al. Outcomes of Short Fusion versus Long Fusion for Adult Degenerative Scoliosis: A Systematic Review and Meta-analysis. Orthop Surg 2017; 9: 342-349
• 3 Chen PG, Daubs MD, Berven S. et al. Surgery for Degenerative Lumbar Scoliosis: The Development of Appropriateness Criteria. Spine (Phila Pa 1976) 2016; 41: 910-918
• 4 Cho KJ, Suk SI, Park SR. et al. Short fusion versus long fusion for degenerative lumbar scoliosis. Eur Spine J 2008; 17: 650-656
• 5 Wang G, Hu J, Liu X. et al. Surgical treatments for degenerative lumbar scoliosis: a meta analysis. Eur Spine J 2015; 24: 1792-1799
• 6 Li Y, Ou Y, Zhu Y. et al. Effectiveness of Short-Segment Fixation versus Long-Segment Fixation for Degenerative Scoliosis with Cobb Angle 20°~40°: A Retrospective Observational Study. Med Sci Monit 2020; 26: e923656
• 7 Cho KJ, Kim YT, Shin SH. et al. Surgical treatment of adult degenerative scoliosis. Asian Spine J 2014; 8: 371-381
• 8 Cawley DT, Takemoto M, Boissiere L. et al. The Impact of Corrective Surgery on Health-Related Quality of Life Subclasses in Adult Scoliosis: Will Degree of Correction Prognosticate Degree of Improvement?. Eur Spine J 2021; 30: 2033-2039
• 9 Diebo BG, Henry J, Lafage V. et al. Sagittal deformities of the spine: factors influencing the outcomes and complications. Eur Spine J 2015; 24: S3-S15
• 10 Lee CH, Chung CK, Sohn MJ. et al. Short limited fusion versus long fusion with deformity correction for spinal stenosis with balanced de novo degenerative lumbar scoliosis: a meta-analysis of direct comparative studies. Spine (Phila Pa 1976) 2017; 42: E 1126-1132
• 11 Börm W, Meyer F, Bullmann V. et al. Wirbelsäule interdisziplinär. Stuttgart: Schattauer GmbH, Verlag für Medizin und Naturwissenschaften; 2017
• 12 Le Huec JC, Seresti S, Bourret S. et al. Revision after spinal stenosis surgery. Eur Spine J 2020; 29: 22-38
• 13 Schwab F, Lafage V, Patel A. et al. Sagittal plane considerations and the pelvis in the adult patient. Spine (Phila Pa 1976) 2009; 34: 1828-1833
• 14 Berjano P, Lamartina C. Classification of degenerative segment disease in adults with deformity of the lumbar or thoracolumbar spine. Eur Spine J 2014; 23: 1815-1824
• 15 Hosogane N, Watanabe K, Kono H. et al. Curve progression after decompression surgery in patients with mild degenerative scoliosis. J Neurosurg Spine 2013; 18: 321-326
• 16 Tsutsui S, Kagotani R, Yamada H. et al. Can decompression surgery relieve low back pain in patients with lumbar spinal stenosis combined with degenerative lumbar scoliosis?. Eur Spine J 2013; 22: 2010-2014
• 17 Masuda K, Higashi T, Yamada K. et al. The surgical outcome of decompression alone versus decompression with limited fusion for degenerative lumbar scoliosis. J Neurosurg Spine 2018; 29: 259-264
• 18 Matsumura A, Namikawa T, Terai H. et al. The influence of approach side on facet preservation in microscopic bilateral decompression via a unilateral approach for degenerative lumbar scoliosis. Clinical article. J Neurosurg Spine 2010; 13: 758-765
• 19 Sansur CA, Smith JS, Coe JD. et al. Scoliosis research society morbidity and mortality of adult scoliosis surgery. Spine (Phila Pa 1976) 2011; 36: E593-E597
• 20 Simon MJK, Halm HFH, Quante M. Perioperative complications after surgical treatment in degenerative adult de novo scoliosis. BMC Musculoskelet Disord 2018; 19: 10
• 21 Babat LB, McLain RF, Bingaman W. et al. Spinal surgery in patients with Parkinson's disease: construct failure and progressive deformity. Spine (Phila Pa 1976) 2004; 29: 2006-2012
• 22 Schroeder JE, Hughes A, Sama A. et al. Lumbar Spine Surgery in Patients with Parkinson Disease. J Bone Joint Surg Am 2015; 97: 1661-1666
• 23 Cho KJ, Suk SI, Park SR. et al. Selection of proximal fusion level for adult degenerative lumbar scoliosis. Eur Spine J 2013; 22: 394-401
• 24 Fu X, Sun XL, Harris JA. et al. Long fusion correction of degenerative adult spinal deformity and the selection of the upper or lower thoracic region as the site of proximal instrumentation: a systematic review and meta-analysis. BMJ Open 2016; 6: e012103
• 25 Pizones J, Moreno-Manzanaro L, Sánchez Pérez-Grueso FJ. et al. Restoring the ideal Roussouly sagittal profile in adult scoliosis surgery decreases the risk of mechanical complications. Eur Spine J 2020; 29: 54-62